Three young women are leaving the house to attend a concert by The Doors. They tease their roommates Maria and Gladys, who are staying behind. Shortly after they leave, a man arrives outside. He pounds on the door and, visibly wounded, asks for help. Maria lets him in, and while trying to clean his wound she discovers that he is uninjured. The man strikes Maria with a nearby bowl, knocking her unconscious. He drags Gladys upstairs, chanting "Fatty Patty". Maria awakes to water dripping on her forehead. The man tells her to put on a nurse uniform. Maria begs the man for mercy, and tells him that she is a virgin. He binds her arms and feet and leaves her lying on the sofa. Maria prays for help and the man stabs her repeatedly in the back.
Tate is in session with Ben. Tate taunts Ben, revealing he has sexual fantasies about Ben's daughter, Violet. Meanwhile, Ben's cell phone begins ringing. He answers, and grows irate as the caller continues harassing him, responding, "I'm pregnant."
At a skate park, Violet commiserates with Leah. Leah explains that she hasn't told anyone about what happened and as a result her hair has begun turning white, out of fear.
Later, Tate begins watching Violet as she sleeps. The burglar alarm goes off, waking Ben and Vivien. Ben races downstairs to find the front door open. The door to the basement swings open, drawing Ben's attention. He finds Addy giggling downstairs, kneeling on the floor. He sends her home through a door in the basement. Ben walks back upstairs, unaware of a red ball rolling across the floor from Addy's playmate.
Vivien feels that something is wrong with the baby, but Ben thinks she is paranoid, given her last pregnancy.
Ben meets with a new client named Bianca. Bianca tells Ben her dreams of being bisected by a malfunctioning elevator and informs him of his home's inclusion on the "Eternal Darkness Tour". After the session, Ben tries to reach Tate's mother to inform her that he can no longer continue his sessions with Tate due to his interference with Violet. Bianca returns unexpectedly and Ben escorts her out.
In the Langdon's kitchen, Constance is baking cupcakes while Addy is reading a magazine. Addy questions why she does not look like the women in the pictures. Constance has Addy spit in the batter as she mixes in a syrup of ipecac, explaining the effects of severe stomach upset and possible internal bleeding.
Ben jogs, crying and guilty, thinking of his affair with Hayden. Hayden was the woman on the other end of the phone, and the student that Ben had an affair with prior to moving to Los Angeles. Ben encounters Larry, who advises that Ben lie's about his upcoming trip to see Hayden.
Constance brings the toxic cupcakes as a "peace offering" for Violet. Constance detects that Vivien is pregnant and Vivien asks for Constance's advice on the pregnancy. Constance reveals that she herself has had four children (including Addy), three of which were born with defects. The remaining son was "a model of physical perfection", but Constance lost him to "other things". She insists that Vivien's baby is fine. She also reveals that Moira once worked for her.
Vivien presents the cupcake to Violet, but Violet is not in the mood to eat. Vivien offers to have a "girl's night" with Violet, but she declines and goes on to inform her that she knows Vivien is pregnant. Violet tells her mom that if she thinks having a baby will save her marriage, she is wrong. Vivien leaves the room, hurt by Violet's comments, and Violet shouts that she is weak.
Ben visits with Hayden. She claims she is over Ben, and that she wants him there for support while she has an abortion the next day.
Back at the house, a redheaded woman (later called Fiona) is at the door. Vivien sees through the peephole that the woman's scalp is bloody, in a similar fashion to the man in 1968. The woman demands help, but a suspicious Vivien does not let her in. Vivien attempts to call the police, but her phone is nowhere to be found. The banging at the door stops, and Vivien cannot see Bianca through the peephole. An intruder lurks behind Vivien, unnoticed. Violet comes to the mezzanine, and Vivien tells her to lock herself in her room and dial 911. The intruder enters Violet's room as she searches for her phone. Vivien threatens the now masked woman through the door, but a third intruder is already behind her.
Downstairs, the three intruders unmask themselves in front of a captive Vivien and Violet. Bianca is among them. They intend to re-enact the 1968 murders of Gladys and Maria and have brought the bowl that their idolized killer (R. Franklin) used. Violet is to play the role of Gladys and be drowned in the tub upstairs. Violet resists and manages to briefly escape to the kitchen. She is found by Tate, who is inside the house and invisible to the intruders. Tate tells her that she must get the intruders to the basement where they will be dealt with.
In the music room, a bound Vivien trades barbs with the male intruder. She spies Addy behind him and subtly tries to tell her to get help. The man turns, but does not see Addy.
Upstairs, Fiona is filling the tub while Violet is forced to dress in the nurse's garb. The uniform is a reproduction and not vintage. Bianca enters while eating the toxic cupcake. She starts to feel the effects immediately and backs out, heading for a bathroom to be sick. Violet waylays Fiona's plans, informing her that the tub used in the drowning was moved to the basement in a remodel.
Constance is at home, fondling a shirtless young man. As they dance seductively, Addy knocks on the door. An annoyed Constance mistakes Addy's warning about a "bad man next door" to mean Ben. Addy grows insistent, and Constance locks her in a closet surrounded by mirrors. Inside the "bad girl closet", Addy screams.
Bianca vomits in Violet's bedroom waste bin, calling for Fiona. She walks to the bathroom, where Tate (who clearly now can appear anywhere in the house) lures her further. He vanishes into one wall and re-enters the room through the door with an axe in hand. He brutally strikes Bianca in the abdomen with the axe (ironic, given her elevator "nightmare") and she trails through the upstairs hallway, leaving the walls painted with her blood.
The male intruder cuts Vivien's bonds, intending for her to dress in the nurse uniform. She throws it in his face, and as they wrestle Vivien finds the "historic" ashtray and bludgeons him with it. She races upstairs, expecting to find Violet, but only sees the trail of blood.
In the basement, Violet leads Fiona and hides when the lights flicker. Tate beckons Fiona to the tub he has filled for her, and he and Gladys await her.
Vivien and Violet meet on the ground floor and escape from the house, getting Constance's attention.
A ghostly Maria leads the male intruder downstairs. He finds Fiona with her throat slit, beside a filled tub flanked by Maria and Gladys.
At the clinic, Hayden is called in for her procedure. She is sad that Ben can't go in with her. Ben's phone vibrates, and he sees that he has missed 13 calls.
Constance arrives in the basement to join Tate and Moira, as they stand in front of Fiona and the male intruder (both with ruptured throats). Tate does not claim responsibility when asked. Moira says that it was "them". The trio agrees that they must get rid of the bodies if Constance wishes Ben to continue treating Tate.
The police question Ben and Vivien. Ben claims he was seeing a patient, and the police question if it was a "real" patient this time. Confused, Ben reads the file they present on Bianca, who was using the sessions to case the house. The police located her, "practically cut in half" six blocks away. Since the other two attackers are missing, the police assume that they pulled a "Black Dahlia" on her for her reluctance, given their propensity for copycat murders. After the police leave, Ben asks Violet about her claim that Tate helped her escape and how he got into the house. Violet, angry with Ben, is happy that Tate was there when Ben was not. She also goes on to tell Vivien that she was very brave. Ben points out to Vivien that he is home now, but she says that he is not, as she plans on selling the house.
GigiGigi lived in the Murder House in 1968 with Maria, Gladys, and at least two other girls. The house was serving as a dormitory for nursing students in the 1960s. She was the dominant and popular girl of the house, and she was very sexually active. She invited Maria to come with her and two other girls to a concert featuring The Doors, which Maria politely refused, saying she needed to study.
- The 1968 scenes were not filmed on a set, but in the Rosenheim Mansion. 
- Commentary: Stack, Tim (2011-10-05). Ryan Murphy talks premiere, his favorite scene, and identity of Rubber Man (en). Entertainment Weekly.
- During the opening scene from 1968 the soundtrack plays music from the movie "Psycho" which was released in 1960.
- Gladys' prayer is an Act of Resignation. It is a common prayer for Catholics when they prepare for death.
- Drew Powell, who plays Det. Collier can now be seen as mob enforcer Butch on "Gotham".
- Constance Langdon: "Is there anything more wonderful than the promise of a new child... or more heartbreaking when that promise is broken?"
- Vivien Harmon: "Well, I appreciate it. I'm not usually much of a cupcake girl myself..."
- Van Johnson - Constance mentions that her husband looked like this actor.
- If the students living here presumably cleaned up the basement, why are the specimen jars and bloody surgical tools there in 1978?
- Who is Mrs. Langdon really, and is Ben actually talking to her?
- Why is Constance trying to poison Violet?
- Who is Constance's "gentleman caller"?